INSURANCE

Will Medicare Cover My Equipment?

Unfortunately, Medicare and Medicare replacement/supplemental policies DO NOT cover this equipment. Medicare considers this equipment ‘“Not Reasonable and Necessary” and states this in their Explanation of Benefits.

Medicare will deny all payments for this equipment.

“CMS has confirmed that these devices are statutorily non-covered because they do not fall within a Medicare benefit category. These types of devices are considered “precautionary devices” and alco can be used for purposes other than the treatment of an illness or injury..... For dates of service after January 1, 2004, the code E0190 (POSITIONING CUSHION/PILLOW/WEDGE, ANY SHAPE OR SIZE) must be used. For all dates of service, the chair-like device should be coded as A9270.”

CMS, Centers for Medicare and Medicaid Services

Scouter Medical will provide all paperwork necessary to file for reimbursement of your face down equipment rental including:

1) A Certificate of Medical Necessity (CMN) describing the physics of the surgery and listing the diagnosis and equipment codes. The CMN provides a space for your physician to sign at a a post-op exam indicating he/she considers the face down equipment medically necessary and has recommended it,

2) an Out-Of-Network Exception Request form (as we and all companies that provide this face down equipment are out-of-network suppliers),

3) an insurance provider Medical Member Claim Form (downloaded from your insurance provider website),

4) an Itemized and Coded PAID receipt indicating member, NOT SUPPLIER, is to be reimbursed.

Will insurance cover my equipment? Still working and insured through work?

Scouter Medical will provide the necessary insurance paperwork to file for reimbursement for your equipment expense. Our billing department has 22-yrs of claims experience and is familiar with the coverage policies of all major medical insurances including AARP, Aetna, Blue Cross & Blue Shield, Cigna, Humana, Medica, Meritain, UMR, United Health Care, etc.